Concessions needed to get Health Bill through

And this leader is being written ahead of the BMA's special representative meeting, which takes place as GP goes to press.

Health secretary Andrew Lansley reportedly faces a revolt from Liberal Democrats demanding Health Bill concessions including restoration of the NHS as the preferred provider, only allowing new private providers where there is no risk of 'cherry-picking'; stopping sub-contracting of NHS commissioning to private companies; and an NHS based on co-operation rather than competition, not the market.

GP's exclusive with NHS chief executive Sir David Nicholson, recently appointed as NHS Commissioning Board chief executive, also indicated a compromise on practice boundaries abolition could be struck.

Meanwhile, at the Scottish LMCs conference in Glasgow last week, representatives backed involvement with commissioning and Scotland's health secretary Nicola Sturgeon pledged it would not follow England's lead to increase competition and privatisation in the NHS.

Our exclusive interview with GPC Scotland chairman Dr Dean Marshall reveals a reluctance to use the term 'commissioning' to effectively describe the same practice in Scotland, such is UK GP division on the issue.

Mr Lansley was questioned by GPs last week about his reforms, which may have opened some eyes in Richmond House about the hostility facing the Health Bill in some quarters of general practice. This is likely to be reinforced by this week's BMA special representative and Council meetings.

Facing disenchantment within the coalition government as well as the medical profession, now is clearly the time for Mr Lansley to make the concessions needed to get the Health Bill through.

We've outlined some areas here where movement is demanded. There should be some indication soon about exactly how far he is prepared to go.